Provider Demographics
NPI:1033302690
Name:XAVIER, GLENN F (LMSW)
Entity Type:Individual
Prefix:MR
First Name:GLENN
Middle Name:F
Last Name:XAVIER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 WASHINGTON AVE STE LL
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3039
Mailing Address - Country:US
Mailing Address - Phone:203-530-8980
Mailing Address - Fax:
Practice Address - Street 1:299 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3026
Practice Address - Country:US
Practice Address - Phone:203-288-4288
Practice Address - Fax:203-776-1982
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2023-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical